Limited Access Death Master File Subscriber Certification Form (Derived from the Social Security Administration's Death Master File)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NTIS FM161 National Technical Information Service, Limited Access Death Master File (Derived from the Social Security Administration Death Master File) Subscriber Certification Form	Form	New	Available
NTIS.DMF Certification Form.30DayFRN.031214.doc	Supplementary Document	Uploaded 2014-03-13	Available
Ltr to OMB from DOC-CIO.NTIS.DMF.Emerg.pdf	Supplementary Document	Uploaded 2014-03-13	Available
NTIS.DMF Cert Prog SuppStmt.REVISED.032014.doc	Supporting Statement A	Uploaded 2014-03-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210702	National Technical Information Service, Limited Access Death Master File (Derived from the Social Security Administration Death Master File) Subscriber Certification Form	Form	New

ICR Details

OMB Control No: 0692-0013	ICR Reference No: 201403-0692-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOC/NTIS	Agency Tracking No:
Title: Limited Access Death Master File Subscriber Certification Form (Derived from the Social Security Administration's Death Master File)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 03/24/2014
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/21/2014
	Date Received in OIRA: 03/13/2014
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	6 Months From Approved
Responses	700	0	0
Time Burden (Hours)	1,400	0	0
Cost Burden (Dollars)	140,000	0	0

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Abstract: To collect information necessary to support the certification process required by Section 203 of the Bipartisan Budget Act of 2013 (Pub. L. 113-67) for members of the public to be given access to the Death Master File containing information about deceased persons during the three-calendar-year period after that person's death.

Emergency Justfication: The form will be used by NTIS to collect information related to the implementation of Section 203 of the Bipartisan Budget Act of 2013 (Pub. L. 113-67) (Act). NTIS will be issuing an interim final rule establishing a temporary certification program for persons who seek access to the Social Security Administration’s Public Death Master File (DMF). Section 203 of the Act prohibits disclosure of DMF information during the three-calendar-year period following death unless the person requesting the information has been certified under a program established by the Secretary of Commerce. The Act directs the Secretary of Commerce to establish a certification program for such access to the DMF. Section 203, “Restriction on Access to the Death Master File,” requires a fee-based certification program for allowable uses of DMF data for any deceased individual within three calendar years of the individual’s death. Authority to carry out Section 203 has been delegated by the Secretary of Commerce to the Director, NTIS. The Act, signed into law on December 26, 2013, requires implementation of the certification program 90 days after enactment. NTIS requires emergency clearance of this collection of information under the Paperwork Reduction Act in time to be able to implement the certification program on March 26, 2014.

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Authorizing Statute(s): PL: Pub.L. 113 - 67 203 Name of Law: Bipartisan Budget Act of 2013
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
National Technical Information Service, Limited Access Death Master File (Derived from the Social Security Administration Death Master File) Subscriber Certification Form	NTIS FM161	Limited Access Death Master File

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	700	0	0	700	0	0
Annual Time Burden (Hours)	1,400	0	0	1,400	0	0
Annual Cost Burden (Dollars)	140,000	0	0	140,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

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Annual Cost to Federal Government: $140,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/13/2014

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